| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC. Filed as: HAYS INSURANCE BROKERAGE GRP OF NE | — | HARVARD PILGRIM HEALTH CARE OF NE INC- MA | $16K | — | $16K | 1.37% |
| USI INSURANCE SERVICES LLC3 | — | HARVARD PILGRIM HEALTH CARE OF NE INC- MA | $16K | — | $16K | 1.33% |
| USI INSURANCE SERVICES LLC3 | — | HARVARD PILGRIM HEALTH CARE OF NE INC- MA | $3K | — | $3K | 0.26% |
| HAYS COMPANIES, INC.3 Filed as: HAYS INSURANCE BROKERAGE GRP OF NE | — | HPHC INSURANCE COMPANY | $6K | — | $6K | 1.37% |
| USI INSURANCE SERVICES LLC3 | — | HPHC INSURANCE COMPANY | $5K | — | $5K | 1.33% |
| USI INSURANCE SERVICES LLC3 | — | HPHC INSURANCE COMPANY | $1K | — | $1K | 0.26% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62937 PO BOX 62937 VIRGINIA BEACH, VA 23466 | DELTA DENTAL PLAN OF NEW HAMPSHIRE, INC. | $3K | — | $3K | 2.84% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 80 SOUTH 8TH ST STE 700 MINNEAPOLIS, MN 55402 | DELTA DENTAL PLAN OF NEW HAMPSHIRE, INC. | $3K | — | $3K | 2.15% |
| COMBINED SERVICES LLC3 Filed as: COMBINED SERVICES LLC DBA CSONE BEN | PO BOX 1320 CONCORD, NH 03302 | DELTA DENTAL PLAN OF NEW HAMPSHIRE, INC. | $978 | — | $978 | 0.84% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 80 SOUTH 8TH ST STE 700 MINNEAPOLIS, MN 55402 | HARTFORD LIFE AND ACCIDENT | $2K | — | $2K | 6.24% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62937 VIRGINIA BEACH, VA 23466 | HARTFORD LIFE AND ACCIDENT | $2K | $58 | $2K | 6.05% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF FLORIDA INC | 100 RIALTO PLACE STE 900 MELBOURNE, FL 32901 | HARTFORD LIFE AND ACCIDENT | $0 | $192 | $192 | 0.51% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62937 PO BOX 62937 VIRGINIA BEACH, VA 23466 | RED TREE INSURANCE COMPANY, INC. | $492 | — | $492 | 5.40% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 80 SOUTH 8TH ST STE 700 MINNEAPOLIS, MN 55402 | RED TREE INSURANCE COMPANY, INC. | $403 | — | $403 | 4.43% |
| COMBINED SERVICES LLC3 Filed as: COMBINED SERVICES LLC DBA CSONE BEN | PO BOX 1320 CONCORD, NH 03302 | RED TREE INSURANCE COMPANY, INC. | $134 | — | $134 | 1.47% |
No Schedule C service providers reported on this filing.
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 134 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 138 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HARVARD PILGRIM HEALTH CARE OF NE INC- MA | 166 | $1.6M |
| Dental | DELTA DENTAL PLAN OF NEW HAMPSHIRE, INC. | 238 | $116K |
| Vision | RED TREE INSURANCE COMPANY, INC. | 161 | $9K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 134 | $38K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 134 | $38K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 134 | $38K |
| Prescription drug(2 contracts, 2 carriers) | HARVARD PILGRIM HEALTH CARE OF NE INC- MA | 166 | $1.6M |
| Other | HARTFORD LIFE AND ACCIDENT | 134 | $38K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 238 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.